输卵管性不孕症中医证型分布及相关危险因素的Meta分析

发布时间：2018-06-10 01:44

本文选题：输卵管性不孕症 + 证型　；参考：《河南中医药大学》2016年硕士论文

【摘要】：目的:通过检索近15年国内外发表有关输卵管性不孕症(tubal factor infertility,TFI)证型及相关危险因素的文献,统计出本病临床常见中医证型,采用Meta分析来综合评价TFI临床常见致病危险因素及其关联强度,为该病的早期预测提供循证依据从而提高我们对本病的认识及诊断治疗水平。方法:通过Pubmed、Cochrane、SCI数据库、CNKI、万方、维普等数据库进行网上检索,同时手工检索河南中医学院图书馆2000年以后关于TFI的书籍、杂志等,并对纳入文献的参考文献进行筛查检索。根据已制定的纳入标准及排除标准对所检索到的文献进行分类及筛选,以中医证型和相关危险因素为信息点对符合要求的文献进行信息提取及统计分析。结果:最终共纳入5篇有关TFI中医证型方面的文献,进行统计分析后结果如下:TFI中医证型分布以气滞血瘀型、肾虚血瘀型、湿热瘀组型为主,其中气滞血瘀型占53.5%、肾虚血瘀型占18.5%、湿热瘀组型占17.3%。最终共纳入7篇有关TFI相关危险因素的文献。进行Meta分析结果如下:盆腔炎病史:合并效应量OR值为5.44,95%CI(2.75,10.78),P0.05,其差异具有统计学意义。人工流产史:合并效应量OR值为1.30,95%CI(0.98,1.74),P0.05,其差异无统计学意义。阑尾炎史:合并效应量OR值为3.23,95%CI(1.64,6.35),P0.05,其差异具有统计学意义。初次性生活年龄20岁:合并效应量OR值为3.46,95%CI(2.11,5.68),P0.05,其差异具有统计学意义。异位妊娠史:合并效应量OR值为7.80,95%CI(3.82,15.93),P0.05,其差异具有统计学意义。NG/CT/UU感染史:合并效应量OR值为6.68,95%CI(3.69,12.11),P0.05,其差异具有统计学意义。结核病史:合并效应量OR值为6.24,95%CI(2.81,13.85),P0.05,其差异具有统计学意义。结论:本研究对TFI临床上常见中医证型及主要危险因素进行了统计分析,分析结果为:TFI的中医证型分布以气滞血瘀型、肾虚血瘀型、湿热瘀组型为主,其中气滞血瘀型占53.5%、肾虚血瘀型占18.5%、湿热瘀组型占17.3%。TFI相关危险因素分别为:盆腔炎病史,阑尾炎史,初次性生活年龄20岁,异位妊娠史,NG/CT/UU感染史,结核病史,其联系强度由强到弱为:异位妊娠史,NG/CT/UU感染史,结核病史,盆腔炎病史,初次性生活年龄20岁,阑尾炎史。而人工流产并不是引起TFI的危险因素。
[Abstract]:Objective: to find out the common TCM syndromes of tubal factor infertility syndrome and related risk factors published at home and abroad in recent 15 years. Meta-analysis was used to evaluate the common clinical risk factors and the associated strength of TFI in order to provide evidence-based basis for early prediction of TFI and to improve our understanding of the disease and the level of diagnosis and treatment. Methods: the database CNKI, Wanfang and Weip were searched by Pubmedus Cochranege sci database, and the books and magazines on TFI of Henan Institute of traditional Chinese Medicine library after 2000 were searched by hand, and the references included in the literature were screened and searched. According to the inclusion criteria and exclusion criteria, the retrieved documents were classified and screened, and the information extraction and statistical analysis were carried out based on the information points of TCM syndromes and related risk factors. Results: five articles about TCM syndromes of TFI were included. The results were as follows: qi stagnation and blood stasis type, kidney deficiency and blood stasis type, dampness and heat stasis type were the main types of TCM syndromes. Qi stagnation and blood stasis type accounted for 53.5%, kidney deficiency and blood stasis type accounted for 18.5%, dampness and heat stasis type accounted for 17.3%. A total of 7 articles on TFI-related risk factors were included. The results of meta-analysis were as follows: the history of pelvic inflammatory disease: the OR value of combined effect was 5.44 卤95 and the difference was statistically significant. The history of induced abortion: the OR value of the combined effect was 1.3095 CI 0.981.74 P0.05.The difference was not statistically significant. History of appendicitis: the OR value of the combined effect was 3.23 ~ 95CI1.646.35 / P0.05.The difference was statistically significant. The age of the first sexual life was 20 years old: the OR value of the combined effect was 3.46% 95% and 2.115.68% P0.05.The difference was statistically significant. History of ectopic pregnancy: the OR value of the combined effect was 7.80 / 95CII 3.82 / 15.93 / P 0.05, the difference was statistically significant. The history of CTU infection was statistically significant. The OR value of the combined effect was 6.68 / 95 / CI 3.69 / 12.11 / P0.05, and the difference was statistically significant. History of tuberculosis: OR value of combined effect was 6.24% 95% (P 0.05), and the difference was statistically significant. Conclusion: the common TCM syndromes and main risk factors of TFI were statistically analyzed. The results showed that the TCM syndromes of 10 TFI were mainly qi stagnation and blood stasis type, kidney deficiency and blood stasis type, damp-heat and blood stasis type. Among them, Qi stagnation and blood stasis type accounted for 53.5%, kidney deficiency and blood stasis type accounted for 18.5, damp-heat stasis group type accounted for 17.3.TFI related risk factors were: history of pelvic inflammation, history of appendicitis, age of first sexual life 20 years old, history of ectopic pregnancy and history of NGP / CTUU infection, history of tuberculosis. The connection intensity from strong to weak is: history of ectopic pregnancy, history of NGP CT-UU infection, history of tuberculosis, history of pelvic inflammation, first sexual life age of 20 years, history of appendicitis. Abortion is not a risk factor for TFI.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.14

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